Detection and global quantification of cardiovascular molecular calcification by fluoro18-fluoride positron emission tomography/computed tomography--a novel concept

The aim of this study was to examine the degree and prevalence of regional (aorta) and global (cardiac) fluorine-18-sodium fluoride ((18)F-NaF) uptake by positron emission tomography (PET)-computed tomography (CT) as evidence for calcification in the atherosclerotic plaques in the aorta and the heart as a function of age. Image data from 51 patients, who had undergone whole-body (18)F-NaF-PET/CT, were evaluated retrospectively. Cardiac and arterial (aorta) radiotracer uptakes were analyzed quantitatively by measuring standard uptake values (SUV). This approach involved examining the entire heart and various aortic segments as identified by CT. By combining CT and PET data, regional and global concentrations of this molecule were calculated and correlated with age over the decades. (18)F-NaF uptake in the heart and aorta increased significantly with advancing age (P<0.01). The Pearson correlation coefficient for the mean (18)F-NaF uptake of cardiac region and 5 age groups was 0.92 (P=0.003) and for aorta and 5 age groups was 0.97 (P=0.004). In conclusion, these preliminary data indicate the feasibility of (18)F-NaF-PET/CT for measurement of regional and global calcification of the heart and major arteries. The (18)F-NaF-PET/CT may provide highly relevant information about the state of calcified plaque before structural calcification is detectable by standard CT techniques. This, therefore, may allow for earlier intervention for risk reduction in cardiovascular diseases. Further studies are needed to validate the role of this promising technique in the management of patients with suspected atherosclerosis.